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The paradigm of pediatric diabetes – art vs. science. Meeting Highlights – 31st Annual ISPAD Meeting, August 31 – September 3, 2005, Krakow, Poland
Author(s) -
Acerini Carlo L,
Cameron Fergus J
Publication year - 2005
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/j.1399-543x.2005.00135.x
Subject(s) - medicine , presentation (obstetrics) , library science , pediatrics , family medicine , surgery , computer science
International Society for Pediatric and Adolescent Diabetes (ISPAD) meetings have traditionally been comprised of a mixture of quantitative scientific research, qualitative research, opinion, and consensus. At its best, this combination creates a milieu where science informs clinical practice, yet at its worst, it might produce a ‘polyglot’ of non-consensual ‘agreement’ and selective science that is used to justify opinion which results in confusion, discord, and inconsistent clinical practice. Clearly, the struggle to achieve the former outcome is the priority for ISPAD and based on the content of this year’s meeting program, there is good evidence that a further step has been made in the right direction. One of the main highlights of ISPAD 2005 was the excellent symposium discussing the ‘new’ hypotheses about the etiology of type 1 diabetes mellitus (T1DM). Professor Mikael Knip (Helsinki, Finland, Abstract not submitted) discussed evidence supporting the ‘Hygiene Hypothesis’ using the geographic juxtaposition of Finland and the adjacent Karelia territory of the Russian Federation as a natural laboratory to inform on this debate. While the Finns share a common human leukocyte antigen (HLA) genotype (DQ subtype) with the population in Karelia, the incidence rates of T1DM between 1990 and 1999 showed a sixfold difference between the two areas. Cross-sectional data reveal serological evidence of markedly different exposure rates to various infectious agents (e.g., Helicobacter pylori; Toxoplasma gondii; coxsackie A, and hepatitis A). While total immunoglobulin E (IgE) levels were greater in the Karelian population, the allergy-specific IgE levels were three to fourfold less. Counterintuitively, Karelian school children showed higher rates of positivity to islet cell antibodies (ICAs), insulin autoantibodies (IAAs), and glutamic acid decarboxylase antibodies but lower rates of IA2. A critical review of the immunologic Th1/Th2 paradigm and the experience of other populations such as Japan suggest, however, that exposure to infectious agents per The citations appearing after the various authors’ names correspond to the Abstracts for the 31st Annual Meeting of the International Society for Pediatric and Adolescent Diabetes (ISPAD), August 31 –September 3, 2005, Krakow, Poland. Issue, PEDIATRIC DIABETES, Volume 6, Supplement 3, September 2005. Legend: L, Lecture; O, Oral Presentation; P, Poster Presentation. Pediatric Diabetes 2005: 6: 230–233 # 2005 The Authors Journal compilation # 2005 Blackwell Munksgaard All rights reserved